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Malaria vaccine rolled out for tens of thousands of children

A
large-scale pilot of what has been called the world's first malaria vaccine to
give partial protection to children has begun in Malawi.

The
RTS,S vaccine trains the immune system to attack the malaria parasite, which is
spread by mosquito bites.

Earlier,
smaller trials showed that nearly 40% of the 5-to-17-month-olds who received it
were protected.

Malaria
cases appear to be on the rise again after a decade of success in combating the
deadly disease.

"This
is a landmark moment for immunisations, malaria control, and public
health," Dr Kate O'Brien, Director of Immunisation and Vaccines at the
World Health Organization, told the BBC.

According
to the most recent annual figures, global malaria cases are no longer falling,
sparking concerns about its resurgence.

Malawi
is the first of three countries chosen for the pilot to roll out the vaccine.
It aims to immunise 120,000 children aged two years and below. The other two
countries, Ghana and Kenya, will introduce the vaccine in the coming weeks.

The
three countries were picked because they already run large programmes to tackle
malaria, including the use of bed nets, yet still have high numbers of cases.

How
big a problem is malaria?

Malaria
kills some 435,000 people around the world each year, the majority of them
children. Most of these deaths are in Africa, where more than 250,000 children
die every year, according to the World Health Organization (WHO).

Dr
O'Brien said that malaria is "a really difficult disease to develop a
vaccine against".

An
early trial of the vaccine began in 2009.

"There
were seven countries participating in a large trial where over 15,000 children
participated," Dr David Schellenberg, who has been working on the
development of the vaccine with the WHO, told the BBC's Newsday programme.

"[The
trial] showed pretty clearly that this vaccine is safe and it is efficacious in
terms of its ability to prevent clinical malaria episodes and also severe
malaria episodes," he said.

What
difference will the vaccine make?

RTS,S
has been more than three decades in the making, with scientists from drugs
company GSK creating it in 1987.

Years
of testing supported by a host of organisations, including the Path Malaria
Vaccine Initiative, and costing an estimated $1bn (£770m), have led to this
point.

The
nearly 40% efficacy is not high in comparison with vaccines for other diseases,
but Dr Schellenberg says RTS,S will add to the preventative measures, such as
bed nets and insecticides, already being used.

"Nobody
is suggesting that this is a magic bullet," Dr Schellenberg said.

"It
may not sound like much but we're talking about 40% reduction in severe malaria
which unfortunately still has high mortality even when you have good access to
good treatment," he added.

Dr
O'Brien said the vaccine lasted for at least for seven years and would target
infants because they are most at risk.

The
vaccine needs to be given four times - once a month for three months and then a
fourth dose 18 months later.

Dr
Schellenberg accepted that it might be a challenge for mothers in some areas to
take their children to clinics for all four doses.

It would seem from available accounts that the earliest form of Western-style
health care in Nigeria was provided by doctors brought by explorers and traders
to cater for their own well being.[2] The services were not available to the
indigenes.